Ebola is a scary disease, but it is containable if the proper procedures are put in place, and the hysterical reporting on cable television in the US has actually made the situation worse by discouraging health workers from going to Africa to help out, according to Margaret Aguirre, the Head of Global Initiatives for International Medical Corps (IMC) in Santa Monica. And with dysfunctional healthcare systems in all three of the affected countries - Guinea, Sierra Leone and Liberia - there is a need for foreign help. Apart from treating patients, the most important thing that foreign NGOs can do is train the local health workers to deal with the disease themselves, said Aguirre. There are four crucial lessons - “catching it early, contact tracing (of anyone who might have had contact with someone who has Ebola), safe burial (where relatives do not touch the corpse, which is at a highly infectious stage) and palliative care (replenishing lost fluids).”
Aguirre said that although the Ebola epidemic is far from over, there are already some signs of hope in Liberia’s capital Monrovia, where the number of cases is going down and for the first time there are empty hospital beds. In rural Liberia and in Sierra Leone the case loads are still increasing, but a year after this current outbreak started there is some indication that the virus may be able to be brought under control. “We are now seeing 1,000 new cases every couple of weeks, but the previous warnings of 1.5 million cases by January - we feel we have staved that off,” said Aguirre. “But it is not over yet.” One advance is that the medical aid organizations on the ground like Doctors Without Borders and IMC now know how to handle the disease. With early palliative care survivability goes up by 40%. In the Ebola Treatment Units (ETU’s) run by IMC mortality rates are 60% - but without proper treatment the mortality rates range between 70-90%.
Initially the Ebola epidemic was called “the nurse killer”, said Aguirre, because so many health workers were becoming infected and dying. They lacked understanding of the virus and didn’t have the proper protective equipment. Now there are very strict protocols for suiting up - each health worker has a buddy, whose job it is to ensure their partner’s protective suits are put on properly, that they have no gaps or holes, and that their buddies don’t pass out from the heat inside their suits. With temperatures up to 100 degrees and high humidity, each worker loses 3lbs of water in sweat inside their protective suits in 2 hours. Their boots have 6 inches of water in them when they take them off. And they have to remember the details of each patient they attended to in those 2 hours, because they cannot write anything down inside the ETU, since the pen and paper could potentially be contaminated with the virus.
Apart from prompt treatment, public information campaigns are crucial. “Initially there were conspiracy theories - that Ebola was some mythical thing, or that it was brought by the CIA - now the messaging is that 'Ebola is real and you need treatment'.”
Aguirre was very critical of the proposed travel restrictions, which she said do nothing more than “incentivize people to lie, while preventing health care workers and supplies from getting in”. And she said the 21 day quarantines imposed by states like New York, New Jersey and California on anyone returning from west Africa are also counter-productive. Ebola is not contagious unless someone is showing symptoms, but the prospect of quarantine is a disincentive for health workers considering volunteering to go. And ultimately the outbreak won’t be stopped if we think we can wall it off in Africa and ignore it. “It is like a fire - you can’t just put towels under the door and hope to keep the fire out - the smoke will come in and you will die. You have to fight the fire.” And if restrictions prevent health care workers from going to west Africa and stop supplies from getting in, “you will not put out the fire.”